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| 1 | Passive expansion of sub-maximally dilated transjugular intrahepatic portosystemic shunts and assessment of clinical outcomes显示文摘AIM To assess for passive expansion of sub-maximally dilated transjugular intrahepatic portosystemic shunts(TIPS) and compare outcomes with maximally dilated TIPS.METHODS Polytetrafluoroethylene covered TIPS(Viatorr) from July 2002 to December 2013 were retrospectively reviewed at two hospitals in a single institution. Two hundred and thirty patients had TIPS maximally dilated to 10 mm(m TIPS), while 43 patients who were at increased risk for hepatic encephalopathy(HE), based on clinical evaluation or low pre-TIPS portosystemic gradient(PSG), had 10 mm TIPS sub-maximally dilated to 8 mm(sm TIPS). Group characteristics(age, gender, Model for End-Stage Liver Disease score, post-TIPS PSG and clinical outcomes were compared between groups, including clinical success(ascites or varices), primary patency,primary assisted patency, and severe post-TIPS HE. A subset of fourteen patients with sm TIPS underwent follow-up computed tomography imaging after TIPS creation, and were grouped based on time of imaging(< 6 mo and > 6 mo). Change in diameter and crosssectional area were measured with 3D imaging software to evaluate for passive expansion.RESULTS Patient characteristics were similar between the sm TIPS and m TIPS groups, except for pre-TIPS portosystemic gradient, which was lower in the sm TIPS group(19.4 mm Hg ± 6.8 vs 22.4 mm Hg ± 7.1, P = 0.01). Primary patency and primary assisted patency between sm TIPS and m TIPS was not significantly different(P = 0.64 and 0.55, respectively). Four of the 55 patients(7%) with sm TIPS required TIPS reduction for severe refractory HE, while this occurred in 6 of the 218 patients(3%) with m TIPS(P = 0.12). For the 14 patients with follow-up computed tomography(CT) imaging, the median imaging follow-up was 373 d. There was an increase in median TIPS diameter, median percent diameter change, median area, and median percent area change in patients with CT follow-up greater than 6 mo after TIPS placement compared to follow-up within 6 mo(8.45 mm, 5.58%, 56.04 mm^2, and 11.48%, respectively, P = 0.01).CONCLUSION Passive expansion of sm TIPS does occur but clinical outcomes of sm TIPS and m TIPS were similar. Sub-maximal dilation can prevent complications related to overshunting in select patients. | Michael C Hsu Charles N Weber S William Stavropoulos Timothy W Clark Scott O Trerotola Richard D Shlansky Goldberg Michael C Soulen Gregory J Nadolski | 2017 | World Journal of Hepatology2017，9，12： | 11 |
| 2 | Multichannel texture analysis using localized spatial filters显示文摘 | Bovic A C Clark C Geisler W S | 1990 | IEEE Transactions on Pattern Analysis and Machine Intelligence1990，12，1： | 2 |
| 3 | Theory and simulation of high-power microwave generation in a magnetically insulated transmission line oscillator显示文摘 | Lemke R W Clark M C | 1987 | J App Phys1987，62，8： | 2 |
| 4 | Environment and Development: Sustainability Science 显示文摘 | Kates R W Clark W C Corell R | 2001 | Science2001，，292： | 1 |
| 5 | Multichannel Texture Analysis Using Localized Spatial Filters 显示文摘 | BOVIK A C CLARK M GEISLER W S | 1990 | IEEE Transaction on Pattern Analysis and Machine Intel ligence1990，12，1： | 1 |
| 6 | Investigation of a load-limited, magnetically insulated transmission line oscillator(MILO)显示文摘 | Lemke R W Calico S E Clark M C | 1997 | IEEE Trans Plasma Sci1997，25，2： | 1 |
| 7 | Fixed abrasive diamond wire machining-part Ⅰ:process monitoring and wire tension force显示文摘 | Shih A J Hardin C W Lemaster R L McSpadden S B | 2003 | International Journal Machine Tools & Manufacture2003，43，： | 1 |
| 8 | Flight string models for aircraft fleeting and routing 显示文摘 | C Bamhart N L Boland L W Clarke | 1998 | Transportation Science1998，32，3： | 1 |
| 9 | Generalized Predictive Control显示文摘 | Clarke D W Mohtadi C Tufts P S | 1987 | Automatic1987，23，2： | 1 |
| 10 | Icthyophthirius muhifiliis has membrane-associated immobilization antigens显示文摘 | Dickerson H W Clark T G Findly R C | 1989 | J Protozool1989，36，2： | 1 |
| 11 | Computation of un- steady nonlinear flows in cascades using a harmonic balance teehnique显示文摘 | HALL K C THOMAS J P CLARK W S | 2002 | AIAA Journal2002，40，5： | 1 |
| 12 | A novel tryptase inhibitor, APC 366, inhibits allergeninduced airway and inflammatory responses in allergic sheep 显示文摘 | Clark J M Moore W R Fishman C E | 1995 | Am J Respir Crit Care Med1995，152，6： | 1 |
| 13 | Environment and Development: Sustainability Science显示文摘 | Kates R W Clark W C Corell R | 2001 | Science2001，292，： | 1 |
| 14 | A Develop- ment Study of data envelopement analysis in measuring the efficiency of maintaince units in the US air force 显示文摘 | Charnes A Clark C T Cooper W W | 1985 | Annals of Operational Research1985，2，1： | 1 |
| 15 | A novel plant pro- tein disulfide isomerase involved in the oxidactive folding of cystine knot defense proteins 显示文摘 | Gruber C W Cemazar M Clark R J | 2007 | Journal of Biological Chem- istry2007，22，： | 1 |
| 16 | Transient expression and insertional mutagenesis of Puccinia triticina using biolistics显示文摘 | CRAIG A W LES J S GUUS B CLARKE G RICHARD C S MERLE E JOHN P F | 2005 | Functional & Integrative Genomics2005，12，： | 1 |
| 17 | Dorso-ventral compartments and origin of apical ectodermal ridge in developing chick limb 显示文摘 | Altabef M Clarke J D W Tickle C | 1997 | Development1997，124，： | 1 |
| 18 | Characterization of renal allograft rejection by urinary proteomic analysis 显示文摘 | Clarke W Silverman B C Zhang Z | 2003 | Ann Surg2003，237，5： | 1 |
| 19 | Investigation of a load-limited, magnetically insulated transmission line oscillator(MILO)显示文摘 | Lemke R W Calico S E Clark M C | 1997 | IEEE Trans Plasma Sci1997，25，： | 1 |
| 20 | Environ- ment and Development: Sustainability Science 显示文摘 | Kates R W Clark W C Corell R | 2001 | Science2001，292，5517： | 1 |
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